Iowa Health Insurance: 2021 Coverage Guide

Fran
Fran Majidi
November 3, 2020

There are several health insurance options in Iowa, which makes it important to understand what you need before buying health coverage. After you gather some important information, you'll want to compare different health plans to make sure you’re getting the best value for your health care. If you’re buying coverage for yourself or for a family, you can get the coverage you need at the best prices with SmartFinancial. But first things first. Let’s make sure you know the deadline to enroll, so you don’t have to wait another year. Of course, if you have a qualifying event, you can buy insurance any time of year.

When Is Open Enrollment in Iowa?

November 1, 2020 - December 15, 2020. Coverage begins on January 1, 2021.

How to Get Health Insurance in Iowa

There are different levels of protection you can buy, and it is important to choose a tier based on how many prescription drugs you take and how often you see a doctor. It’s always a good idea to look at the previous year when making a projection. Consider also whether your previous year’s coverage was sufficient or if you paid too much out of pocket.

Once you determine what your costs will be for the next year, compare health insurance companies and health insurance quotes. After you submit a form, you’ll get several policies to choose from. You can buy coverage or speak with an agent to ask questions.

What Types of Health Insurance Are Available in Iowa?

HMOs, EPOs, PPOs and POS plans are the most common health plans available in Iowa. But you may also buy catastrophic and short-term health plans as well. You’ll find that most plans are available in bronze, silver, gold and platinum. Keep in mind that a bronze plan covers about 60% of costs, silver covers about 70%, gold 80% and platinum 90%. A gold plan costs 37% more than a bronze plan but may save you money if you visit doctors more frequently than not. So you may pay more per month for a platinum plan but you’ll pay little to nothing when you buy medication or visit care providers.

Does Health Insurance Cover Pre-existing Conditions?

It is no longer legal for marketplace health plans to deny anyone health insurance coverage based on pre-existing conditions.

Compare Health Insurance Plans in Iowa

Do I Qualify for a Special Enrollment Period?

Common reasons people qualify for a special enrollment period:

  • If you lose or switch jobs or start your own business, you are able to buy health insurance outside the open enrollment period.
  • If you are covered on your parents’ health insurance plan and turn 26 outside the open enrollment period, you can enroll in an individual health plan.
  • If you had coverage but you moved where it is not valid, you can sign up for a new health plan.
  • If you elected a Cobra extension of your previous employer’s group health benefits and reached the deadline, you can enroll in a new health plan.
  • If you share coverage with a spouse but you divorce, you can enroll in a new health insurance plan.
  • If you get married, the two of you can buy two new individual health plans or one family plan together.
  • The birth or adoption of a child is a qualifying event and you can buy health insurance for that child.
  • If you shared health care coverage with a spouse or partner but that person passed away, you can enroll in an individual health plan.
  • If you shared health insurance with a partner or spouse but they lost coverage for a qualifying reason, you are eligible to buy an individual plan or buy coverage with that spouse/partner again.

Is Health Insurance Required in Iowa?

No, you do not get a tax penalty for not having health insurance in Iowa. Only California, Massachusetts, New Jersey, Vermont, Rhode Island, and DC still require health insurance. Despite it not being mandatory, buying health insurance helps avoid medical bankruptcy.

How Much Is Health Insurance in Iowa?

The average cost of health insurance in Iowa for a 40 year old is about $561 a month. Health insurance gets more expensive the older you get. Tobacco use increases health insurance rates.

How to Save on Health Insurance in Iowa

Save on health insurance in Iowa! Compare rates based on the tier system. Beforehand, you’ll want to estimate your medical costs for the year to see which plan makes sense for your needs.

Medicare in Iowa

Medicare is health insurance coverage for Americans ages 65 years and older. The government also allows younger people with disabilities to enroll in the program. Individuals with End-Stage Renal Disease (a permanent kidney failure treated with dialysis or a transplant) can also sign up as can some individuals with severe mental health issues. Others who qualify for Medicare disability coverage are individuals with Amyotrophic Lateral Sclerosis (also called Lou Gehrig’s Disease). Most beneficiaries will receive Original Medicare (Parts A and B). Some people buy Medicare Advantage, which includes Part A and B as well as offering vision, dental and prescription drug coverage.

How Many People Are on Medicare in Iowa?

20% of Iowa residents are on Medicare.

How Much Is Medicare in Iowa?

If you do not qualify for Medicare, you can buy it for $458 a month for Part A in 2020 and a standard monthly premium for Medicare Part B was $144.60 for 2020, or even higher depending on income.

Original Medicare vs Medicare Advantage: What’s the Difference?

Medicare is a government subsidized health plan that is available to qualified Americans age 65 and older. Medicare Advantage is sold through private health insurance companies, but these policies are also regulated by the government. Medicare Advantage plans offer the same benefits as Medicare Parts A and B. Medicare Advantage plans also offer more coverage for dental, vision, hearing and prescription drugs. Medicare Advantage plans have a maximum out-of-pocket limit. For 2020, it was $6,700 but many plans set their maximums at a much lower cost. That is why it’s important to compare companies. People who opt for original Medicare can buy Medicare Supplements to help with out-of-pocket costs. You cannot buy both Medicare Advantage and Medicare Supplements. If you enroll in a Medicare Advantage Plan during open enrollment, you will automatically be disenrolled from original Medicare.

How to Get Medicare Coverage in Iowa

Those who receive social security payments will most likely be automatically enrolled in Medicare, but you may have to sign up if you do not receive payments. The easiest way to enroll in Medicare is by working with a trusted insurance agent to get the coverages you want. Just enter your zip code and answer a few simple questions.

Types of Medicare Plans Available

Original Medicare, Medicare Advantage, Medicare Cost Plans (only offered in certain areas), Demonstration/Pilot Programs (also called Research Studies; only offered in certain areas) and Programs of All-Inclusive Care for the Elderly (PACE).

How Do I Qualify for Medicare?

To qualify for Medicare you must be a citizen of the U.S. or have been a legal resident for at least five years. If you are age 65 or older and you/your spouse have worked for at least 10 years (40 quarters) or you have a disability, Amyotrophic Lateral Sclerosis (ALS) or end-stage renal disease (ESRD), you most likely qualify for Medicare.

How Can I Save on Medicare in Iowa?

You can save on Medicare by signing up for Part B as soon as you’re eligible. People who enroll late must pay a penalty every year. If you’re interested in buying Medicare Advantage, you can shop and compare Medicare plans for the best value.

Iowa State Health System Ranking

Ever wonder how your state stacks up when it comes to quality healthcare? The Commonwealth Fund published a report in 2020 on State Health System Performance. They took into consideration the access to quality care, health outcomes, and disparities in all 50 states. The scores for the Iowa Health System are listed below:

  • Iowa: Overall Ranking: 4 of 51
  • Iowa: Overall Performance: Above U.S. Average
  • Iowa: Access and Affordability: 7
  • Iowa: Prevention and Treatment: 1
  • Iowa: Avoidable Hospital Use and Cost: 12
  • Iowa: Healthy Lives: 20
  • Iowa: Health Care Disparities: 9
Find Affordable Health Insurance in Iowa

Iowa Health Insurance Coverage

The people of Iowa have different kinds of health insurance while some Iowa residents are not insured at all. See the breakdown below:

  • Private coverage: 57%
  • Medicaid: 18%
  • Medicare: 20%
  • Uninsured: 5%

Report: America's Health Insurance Plans

Iowa Health Insurance Companies

  • Gundersen Health Plan, Inc.
  • HealthPartners Administrators, Inc.
  • Health Alliance Midwest, Inc.
  • Medical Associates Health Plan, Inc.
  • Wellmark Health Plan of Iowa, Inc.
  • Aetna Life Insurance Company (Iowa)
  • Avera Health Plans, Inc.
  • Sanford Health Plan
  • United Healthcare Services, Inc (Iowa)
  • UnitedHealthcare Insurance Company (Iowa)
  • UnitedHealthcare Plan of the River Valley, Inc.
  • UnitedHealthcare Services Company of the River Valley, Inc.
  • Cigna Health and Life Insurance Company - Iowa
  • Connecticut General Life Insurance Company - Iowa
  • Aetna Health of Iowa Inc.
  • Aetna Health of Iowa Inc (Coventry Health Care of Iowa)
  • Medica Insurance Company - Iowa
  • UnitedHealthcare Military & Veterans Services, LLC
  • Wellmark Synergy Health, Inc.
  • Wellmark Value Health Plan, Inc.

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